“Doing big things is hard,” Ryan said. “Moving
from an opposition party to a governing party comes with growing
pains.” Having had seven years to unite around alternative
legislation, this seems a huge understatement.

Far from being a transitory failure, the fall of Trump-Ryancare
may be the first indication of a paradox. Although Trump helped his
party to win voters a traditional Republican agenda could not, the
nature of his agenda could make Republican party management in
Congress more difficult.

Far from being the end of
divisions, last week’s healthcare debacle might be just the
start.

True, this particular legislation failed because it could not
bridge the divide between members of the “Freedom
Caucus” and so-called “moderates”. The former
thought it left too much of Obamacare’s framework in place.
The latter were worried about the electoral consequences of people
losing insurance. Trump united with the Republican establishment to
push through this supposed middle-way because he wanted to get this
off the agenda and move onto the real economic issues he has
championed: tax cuts, infrastructure spending, discretionary
spending cuts and trade policy reform.

Yet similar divisions surely loom on each. Tax reform should in
theory be easiest. Trump’s campaign promised a traditional rate
cutting and base-broadening programme, reducing the corporate
income tax rate from 35 per cent to 15 per cent, with income tax
rates lowered for all but with the number of rates reduced from
seven to three. He previously said these would be paid for by
eliminating a host of deductions and exemptions.

But many Republicans in Congress want to go further, introducing
a border adjustment tax, which would shift the whole US corporate
income tax code to one taxing activity where it takes place. This
is not economically without merit, but many Republicans doubt that
there will not be significant real impacts on certain industries.
Worse, they worry this is the first step towards a European-style
VAT, enabling a significant new source of revenue for future
administrations. The resistance has started already, with certain
industries, not least retail, lobbying hard.

If we can expect a round of bloody negotiations on tax reform,
then simmering under the surface are bigger divides on
infrastructure. Trump has pledged to raise $1 trillion in public
and private revenue to rebuild infrastructure in the next decade.
He originally planned to harness this through generous tax credits
for private investors and a spate of public-private partnerships,
but his transport secretary Elaine Chao has more recently sounded
open to federal funding.

This would be anathema to Republican fiscal hawks, who believe
the federal role in transportation policy should be minimal, with
decisions left to state and local government. There’s already a
realisation that Trump’s tax credit programme would be hugely
wasteful, giving significant tax relief for projects that would be
undertaken anyway. As we experienced in the UK, there is a fear
that (like PFI) public-private partnerships will be used as a means
of paying for new infrastructure off-balance sheet with big
long-term costs to taxpayers.

Maybe a programme of discretionary spending cuts will be a more
harmonious endeavour? Again, this seems wishful thinking. Last week
Trump launched his budget plans, beefing up military spending by
$54bn but financed by a range of cuts to relatively minor
government departments. The interim period has already seen a host
of special pleading from congressional Republicans to protect
individual programmes, and it’s a not very well kept secret that
most rightly recognise that America’s long-term debt problem is
driven by entitlement spending for old people, which Trump has
pledged not to touch.

And then there’s trade, where public divisions between the
import-hating, economic nationalists and the free-traders even
within Trump’s inner circle are already spilling out into the
press. Trump’s apparent determination to renegotiate Nafta, abandon
semi-agreed trade deals and even threaten across-the-board tariffs
is unlikely to win support from the more free-market elements of
his own party.

Far from being the end of divisions, last week’s healthcare
debacle might be just the start. Indeed, some are asking: if
Republicans cannot agree a deal to repeal and replace Obamacare
when they control the White House, Senate and the House, can they
get anything meaningful done? Governments tend to be at their most
ambitious early in their terms. The Trump government has fallen at
the first hurdle.